Belly, Birth, Baby & Beyond

Your No-Nonsense Guide to Giving Birth in Germany

Back in April 2009, our thoughts turned toward planning a family here in Germany. I didn’t know it at the time, but I was about to face a rather steep learning curve despite being able to speak German decently.

Since then, I’ve met many other women who have encountered similar challenges when it comes to pregnancy and birth – especially when living abroad.

What if there were a way to approach your journey through early motherhood with increasing confidence and ease? I can help! Let me be your guide as you walk your own path to parenthood.

Hi! I’m Carolyn

Welcome to my new blog series! I’m a birth and postpartum doula, childbirth educator, breastfeeding counsellor and mother to four bright, enthusiastic, vibrant children – two boys, two girls; two born in Germany, two born in New Mexico; two born in hospital, two born at home.

I hope that the experience and knowledge I share in this blog series sheds a little light on what you can expect and helps you to navigate pregnancy and birth in a foreign culture and language feeling calm, confident and prepared.

The prenatal care (Schwangerschaftsvorsorge), birth practices and postnatal care that you’ll encounter here in Germany likely differs from what you know of or may have already experienced in your home country.

Let’s get started exploring some of these differences, shall we?

Part One: Choosing a Provider – Choosing Wisely

Have you just moved to Germany? Or, perhaps you’ve been living here for some time? Regardless whether you have an OBGYN or not, now is the time to put some thought and deliberation into the kind of care you and your (future) baby need most.

If you’ve had the good health and the good fortune of not requiring medical care, you may not have had the opportunity to experience just how important the connection and rapport you and your doctor or midwife establish is. The quality of this relationship has the potential to impact your health and your baby’s in significant ways.

Moreover, it can affect how you give birth and how you experience the early days, weeks and months of life with your baby in both powerfully subtle and overt ways.

Learn about the available care options. They can help you to:

choose a provider whom you trust and feel comfortable with

receive the expertise and quality of care right for you and your baby

gain an understanding of the various tests, procedures and options

feel thoroughly prepared to give birth in a foreign country

overcome or circumvent cultural and language barriers

ensure your right to be treated as a respected and equal participant in your and your baby’s healthcare

Ideally, this person:

listens to your concerns and wishes

acknowledges your individual circumstances

offers his/her expertise accordingly

accepts and respects your decision

In Germany, your health insurance covers basic prenatal care provided by a midwife, obstetrician or a combination of the two, as well as in-home postpartum care provided by a midwife. Many German families, however, are currently struggling to find a postpartum midwife and end up having to do without. This is primarily due to steeply rising medical malpractice insurance premiums and restrictive policy requirements which, in recent years, have widely forced numerous self-employed midwives out of the profession and, consequently, has resulted in the dwindling number of midwives.

Don’t be surprised if you must travel some distance to receive prenatal care or even give birth as clinics and hospitals in more rural areas have begun shutting down their obstetrics units because it is not profitable. For more details about the midwifery crisis in Germany, please refer to my blog article The End of German Midwifery as We Know It.

Thus, the extent and availability of your provider options will vary depending on your region and whether you live in a metropolitan area, its outskirts, or out in the countryside.

Because of the high demand and the dire situation facing German midwifery, the key to securing quality care is contacting a care provider as early as possible:

an obstetrician at an independent or group practice (Frauenärztin/Frauenarzt)

an obstetrician with clinic/hospital privileges (Belegärztin/Belegarzt)

**Please note that you are most likely to reap the benefits from continuity of care (i.e. seeing the same provider throughout pregnancy, birth and the early weeks) if you work with a home birth midwife, a Beleghebamme or Belegärztin.

Finding English-speaking medical providers

There are several online sources you can visit to find English-speaking providers:

Popular search engines – often entering your city or region name in conjunction with “English-speaking OB/gynecologist” will yield of a list of English-speaking physicians.

Toytown Germany – use the search function to find an obstetrician in your region; one of the pitfalls of this Internet source, however, is that entries in the various forums are outdated or are not easily navigable.

Hebammensuche.de – this is a nationwide database listing midwives, their contact information, services and any additional languages (Sprachen) spoken. Federal States, such as Bavaria, Berlin or Hamburg may offer searchable databases at the state level.

Kidsgo Magazine – available online and in hardcopy form. Although this resource is published in the German language, it is reasonably user-friendly and reliably up-to-date. It offers a wide variety of sections including “Hebammen”, “Frauenärtze”, birthing locations (Geburtshäuser), childbirth classes (Geburtsvorbereitung), postpartum classes (Rückbildung) covered by insurance and more. Each sub-section lists options according to region and postal code.

Local and regional Facebook groups – let’s face it, Facebook has grown in popularity and is now teeming with loads of groups and communities that enable us to connect with fellow expats.

Alternatively, you can use one of the major search engines to locate local “Frauenärzte”, “Belegärzte”, “Beleghebamme”, or “Hausgeburtshebamme” by combining these words with the name of your city or region and the term “Geburtshilfe”. This gives you the option of scoping out individual websites or calling in to find out if care is offered in any another language.

Watch out for red flags

Not every provider is going to be a good fit for you and your (pre-)pregnancy needs and that’s okay. Be on the lookout for red flags. Red flags are those instances and interactions that give you that unsettled feeling deep down in your gut.

This could mean not feeling heard. It could mean a provider who requires mothers to sign a form, in advance, stating that she will not seek out the advice or care of another physician or midwife during pregnancy. These are clear signs that such a physician may not prioritize mother-centered care.

Always trust your instincts about everything. Never worry about inconveniencing anyone. Your provider’s job is to support you in keeping you and your baby healthy and safe throughout pregnancy and birth.

Know your rights

It doesn’t matter if you are insured publicly or privately, you have the right to seek out a second opinion or to switch providers anytime – without being obliged to state a reason or offer an explanation.

You will only be pregnant with this baby one time; you will only give birth to this baby one time – don't spend even a second worrying about the convenience or inconvenience of others. What matters most is you and your baby.

Auxiliary Care

One of the wonderful advantages of being pregnant in Germany, is the access and availability of a wide breadth of additional healthcare and wellness options that promote maternal health, ease discomfort and alleviate pain.

This includes, but is not limited to:

osteopathic care

chiropractic care

naturopathic care

homeopathic care

physical therapy

massage therapy

nutrition counselling

birth trauma counselling

pregnancy massage

reflexology

acupuncture

acupressure

prenatal yoga

infant first aid

meditation

In a large majority of cases, German health insurance companies compensate little to none of the costs of many of the above health and wellness option unless prescribed by your obstetrician or general practitioner. Fortunately, such alternative options and services are generally quite affordable.

Please stay tuned for part two of the series Belly, Birth, Baby & Beyond – Your No-Nonsense Guide to Giving Birth in Germany which will address the topic of insurance options and coverage.

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